Prognostic value of serum cardiac troponin I and T in chronic dialysis patients: A 1-year outcomes analysis

Apple, Fred S.; Sharkey, Scott W.; Hoeft, Pat; Skeate, Robert; Voss, Ellen M.; Dahlmeier, Beth A.; Preese, L M

doi:10.1016/s0272-6386(97)90201-8

Cited by 103 publications

(57 citation statements)

References 17 publications

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“…26 However, the observation of increased concentrations of cTnT in the serum of patients with ESRF persists, albeit at reduced frequency (see below). 23,24,26^28 Neither Haller et al 28 nor Fredericks et al 29 found evidence of increased skeletal muscle expression of cTnT in uraemic patients. However, this has been disputed by Ricchiuti and co-workers.…”

Section: Serum Troponins and Renal Failurementioning

confidence: 99%

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The significance of serum troponin T in patients with kidney disease: a review of the literature

2004

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The last 10 years have witnessed radical changes in the de nition and diagnosis of the acute coronary syndrome (ACS), including myocardial infarction, as a result of the introduction of sensitive and speci c markers of myocardial damage, the cardiac troponins. One barrier to the universal acceptance of these markers has been the observation that troponin T (cTnT) concentration is commonly increased in the presence of renal failure. Initially it was believed that this constituted an important false positive limitation of the test. This was confounded by problems with the initial cTnT assay and by the observation that troponin I (cTnI) was generally not increased in these patients. However, it has recently been demonstrated that the prognostic signi cance of a raised cTnT concentration in patients with a suspected ACS is unaffected by renal impairment. Further, powerful outcome studies are now being reported demonstrating that raised concentrations of serum cTnT are predictive of mortality in haemodialysis patients. This review summarizes our current understanding of the prevalence and signi cance of raised serum cTnT concentrations in patients with kidney disease and highlights areas where our understanding is incomplete. Evidence suggests that raised troponin concentrations in uraemic patients do indeed re ect myocardial injury. In the future, patients demonstrating this abnormality may be the target for more aggressive cardiac intervention, the advantages of which have been demonstrated in the non-uraemic population.

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Section: Serum Troponins and Renal Failurementioning

confidence: 99%

“…In the ¢rst study to address this, Apple et al 23 observed raised cTnT concentrations (40.2 mg/L) in 12/16 haemodialysis patients with type 1 diabetes. After 1 year, four of these 12 patients had su¡ered a fatal myocardial infarction.…”

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confidence: 98%

The significance of serum troponin T in patients with kidney disease: a review of the literature

2004

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“…Three possible mechanisms were suggested for this elevation: expression of cardiac troponins in regenerating skeletal muscle, cross reactivity errors resulting from the measurement assay, and minor myocardial injury. 11 McLaurin et al determined the levels of CK-MB, cTpT, and cTpI in 24 patients with renal failure. Creatine kinase-MB was above the normal range in 30%, enzymun assay cTpT in 17%, and cTpI in 2.4% of the patients.…”

Section: Discussionmentioning

confidence: 99%

“…10 In a meta-analysis involving 350 patients with CRF, the percentages of falsely elevated CK-MB, cTpT, and cTpI were reported as 10.3, 47, and 2.6%, respectively. 11 Reports regarding the prognostic importance of high troponin levels in chronic renal failure are conflicting. A study involving 49 patients with CRF on dialysis and 83 patients with compensated renal disease showed that high troponin levels are of prognostic importance, 23 but in two other studies no such relationships were observed.…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8][9][10] Reports on the prognostic importance of these false positive results are conflicting. [11][12][13] The aim of this study was to determine cTpI and creatine kinase myocardial isoform (CK-MB) levels and their diagnostic and prognostic significance before and after renal transplantation by comparing myocardial thallium scintigraphy findings. We also sought to determine wheClin.…”

Section: Introductionmentioning

confidence: 99%

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Serum levels of cardiac enzymes before and after renal transplantation

Bozbaş

Korkmaz

Atar

et al. 2004

Clinical Cardiology

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SummaryBackground: Cardiac troponins are very sensitive and specific indicators of myocardial damage; however, they are sometimes found to be increased in patients with end-stage renal disease (ESRD).Hypothesis: The aim of this study was to determine cardiac troponin I (cTpI) and creatine kinase myocardial isoform (CK-MB) levels and to assess their diagnostic and prognostic importance before and after renal transplantation.Methods: Thirty-four patients with ESRD (mean age 31.8 ± 8.6 years, 11 women) were enrolled. Serum levels of cTpI and CK-MB were measured pre-and postoperatively on Days 1, 7, and 30. Patients were followed up for cardiac events, and possible myocardial damage was investigated by exercise thallium-201-labeled myocardial perfusion scintigraphy. Mean cTpI levels were 0.24 ± 0.11 ng/ml (preoperative), and 0.34 ± 0.27 ng/ml (Day 1), 0.26 ± 0.11 ng/ml (Day 7), and 0.28 ± 0.30 ng/ml (Day 30).Results: Compared with preoperative levels, cTpI was increased in 16 (47%), decreased in 6 (17.6%), and did not change in 12 (35.4%) patients. However, the increase did not exceed the myocardial infarction reference level of 2.3 ng/ml in any patient. Mean CK-MB levels were 12.6 (8.7U/l (preop-

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The Troponins

Coudrey¹

1998

Arch Intern Med

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Prognostic value of serum cardiac troponin I and T in chronic dialysis patients: A 1-year outcomes analysis

Cited by 103 publications

References 17 publications

The significance of serum troponin T in patients with kidney disease: a review of the literature

The significance of serum troponin T in patients with kidney disease: a review of the literature

Serum levels of cardiac enzymes before and after renal transplantation

The Troponins

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